Jennifer Marie Fay Damitsian, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN273719 Issued in MA

Practice address

1701 Renaissance Blvd
Ste 110
Edmond, OK 73013-3084

Phone

(405) 844-4978

Fax

(405) 844-0562

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians of Mid-America PC 86 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149
• SSM Health St Anthony Hospital - Midwest Hospital, Midwest City, OK, CCN 370094

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdamitsian400320@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297

  OK

  Medicare reassignment Care Compare group NPD
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550

  OK

  Medicare reassignment NPD
• Mercy Hospital Kingfisher, Inc

  • Critical Access Hospital
  • Kingfisher, OK
  • NPI 1083048417

  OK

  Medicare reassignment NPD
• Mercy Hospital Kingfisher, Inc

  • Diagnostic Radiology Physician
  • Kingfisher, OK
  • NPI 1285064618

  OK

  Medicare reassignment NPD
• Mercy Hospital Logan County Inc

  • Critical Access Hospital
  • Guthrie, OK
  • NPI 1306126818

  OK

  Medicare reassignment NPD
• Mercy Hospital Tishomingo, Inc

  • Emergency Medicine Physician
  • Tishomingo, OK
  • NPI 1972809002

  OK

  Medicare reassignment NPD
• Mercy Hospital Watonga Inc

  • Critical Access Hospital
  • Watonga, OK
  • NPI 1497017529

  OK

  Medicare reassignment NPD
• Oklahoma Arthritis Center, P.C.

  • Rheumatology Physician
  • Edmond, OK
  • NPI 1528036019

  OK

  Medicare reassignment NPD
• Oklahoma Emergency Services PC

  • Emergency Medicine Physician
  • Lawton, OK
  • NPI 1114239795

  OK

  Medicare reassignment NPD
• South Central Emergency Services PC

  • Emergency Medicine Physician
  • Stillwater, OK
  • NPI 1558663724

  OK

  Medicare reassignment NPD
• Emergency Services of Oklahoma PC

  • Emergency Medicine Physician
  • Norman, OK
  • NPI 1215249891

  OK

  Medicare reassignment
• Mercy Hospital Logan County, Inc

  • Rural Health Clinic/Center
  • Crescent, OK
  • NPI 1659652071
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• SSM Health Care of Oklahoma, Inc

  • Ambulance
  • Midwest City, OK
  • NPI 1023603727

  Hospital

  Care Compare affiliation
• SSM Health Care of Oklahoma, Inc

  • General Acute Care Hospital
  • Midwest City, OK
  • NPI 1700471497

  Hospital

  Care Compare affiliation
• St Anthony Shawnee Hospital Inc

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1609939255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 RENAISSANCE BLVD",
            "address_2": "STE 110",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133084",
            "telephone_number": "405-844-4978",
            "fax_number": "405-844-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 RENAISSANCE BLVD",
            "address_2": "STE 110",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133084",
            "telephone_number": "405-844-4978",
            "fax_number": "405-844-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMITSIAN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE FAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN273719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ebony Iman Dallas, MFA
• Viola Dallas, LADC UNDER SUPERVISI
• Wayne Franklin Dallas II, B.F.A.
• Rene Marie Daman, PT, BCBA, LBA
• Keren Elise Damarism., M.C.
• Damon R. Johnson, DDS, PC
• Vernell Dancy
• Angela Marie Danel, MOTRL
• Daniel L Tallerico MD Inc
• Lanell Daniel-Kowalski, LCSW

• All providers in Edmond, OK
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.